Provider Demographics
NPI:1750873790
Name:GARRETT, DAWN AUSTIN (MSW)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:AUSTIN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:E
Other - Last Name:AUSTIN-GARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:4300 S I 10 SERVICE RD W STE 117
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7427
Mailing Address - Country:US
Mailing Address - Phone:504-841-0007
Mailing Address - Fax:504-841-0023
Practice Address - Street 1:4300 S I 10 SERVICE RD W STE 117
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7427
Practice Address - Country:US
Practice Address - Phone:504-841-0007
Practice Address - Fax:504-841-0023
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11758104100000X, 171M00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA433447184Medicaid
LA71M0000XMedicaid
LA125259900Medicaid
LA1275959900Medicaid